- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.26 / $3,228.77 / $7,516.82
| Facility | | $503.26 | $3,228.77 | $7,516.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.57 / $395.11 / $939.20
| Professional | | $320.57 | $395.11 | $939.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $182.89 / $226.55 / $538.10
| Professional | | $182.89 | $226.55 | $538.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.55 / $1,703.55 / $1,728.40
| Facility | | $1,703.55 | $1,703.55 | $1,728.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $423.96 / $591.13 / $949.63
| Professional | | $423.96 | $591.13 | $949.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $1,438.74
| Facility | | $606.10 | $606.10 | $1,438.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.73 / $533.11 / $833.96
| Professional | | $381.73 | $533.11 | $833.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.14 / $472.87 / $744.56
| Facility | | $337.14 | $472.87 | $744.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $413.97 / $417.00 / $606.00
| Professional | | $413.97 | $417.00 | $606.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,188.98 / $2,188.98 / $2,188.98
| Facility | | $2,188.98 | $2,188.98 | $2,188.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.40 / $536.27 / $587.02
| Professional | | $472.40 | $536.27 | $587.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.70 / $429.02 / $817.00
| Professional | | $296.70 | $429.02 | $817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,320.16 / $4,754.80 / $26,542.00
| Facility | | $1,320.16 | $4,754.80 | $26,542.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,571.36 / $2,571.36 / $3,043.65
| Professional | | $2,571.36 | $2,571.36 | $3,043.65 |